Per-Beneficiary Threshold Amounts - 2020 Annual Update

MLN Matters Number: MM11532
Related CR Release Date: October 25, 2019
Related CR Transmittal Number: R4419CP
Related Change Request (CR) Number: 11532
Effective Date: January 1, 2020
Implementation Date: January 6, 2020

Change Request (CR) 11532 updates the annual per-beneficiary incurred expenses amounts now called the KX modifier thresholds and related policy for CY 2020. These amounts were previously associated with the financial limitation amounts that were more commonly referred to as "therapy caps" before the Bipartisan Budget Act of 2018 was signed into law repealing the application of the caps.

For CY 2020, the KX modifier threshold amounts are: (a) $2,080 for Physical Therapy (PT) and Speech-Language Pathology (SLP) services combined, and (b) $2,080 for Occupational Therapy (OT) services. Make sure your billing staffs are aware of these updates.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11532.

 

            Last Updated Thu, 14 Nov 2019 12:29:29 +0000